Detection of oral lesions in vivo with reflectance confocal microscopy in an outpatient clinic setting in India

Oral cancer is a major global concern in countries like India. Although biopsy remains the gold standard, it is invasive and vulnerable to sampling error. Reflectance confocal microscopy (RCM) is a promising non-invasive modality for near-histological in-vivo imaging of oral epithelium. In this study, we aimed to identify key RCM features for diagnosing oral cancer and premalignant lesions using a modified confocal microscope with a rigid telescopic probe. RCM images were evaluated for around 40 features. A total of 97 premalignant, 23 normal, 15 cancer lesions were imaged. Overall accuracy for the validation cohort was 92.6%, confirming potential of RCM for oral premalignant and cancer diagnosis.